NHẬN XÉT DUNG TÍCH TOÀN PHỔI Ở BỆNH NHÂN BỆNH PHỔI TẮC NGHẼN MẠN TÍNH ĐIỀU TRỊ NGOẠI TRÚ TẠI TRUNG TÂM HÔ HẤP BỆNH VIỆN BẠCH MAI

Abstract

Objectives: To evaluate the results of measuring total lung capacity of patients with chronic obstructive pulmonary disease receiving outpatient treatment at the respiratory center of Bach Mai hospital. Subjects and methods: A cross-sectional study was carried out on 211 patients with a confirmed diagnosis of COPD according to GOLD 2020 who were treated as outpatients at the respiratory center of Bach Mai hospital from August 2021 to August 2022 and agreed to participate in the research. Research subjects’ medical history, clinical and para-clinical examination, and measure plethysmography were taken to record research indicators. Results: Research subjects’ average age was 70.12 ± 7.99 years old; male/female ratio = 25/1; 94.2% of the patients smoked, the average smoking volume was 23.27 ± 13.31 packet x year; 83.4% of the patients had co-morbidities, the most common diseases were hypertension (43.6%); the most common functional symptoms are dyspnea (98.1%), cough (92.9%), sputum production (72.3%); 19.9% of the patients ​​suffered from depression; the most common physical symptoms were decreased or absent alveolar murmur (91.5%), echocardiographic percussion (71.6%), barrel chest (49.3%); 43.2% of the patients had abnormalities on electrocardiogram, the most common abnormalities were right atrial enlargement (16.1%); 86.4% of the patients experienced increased pulmonary artery pressure on echocardiography, at mild or moderate level; 78.6% of the patients had alveolar spaces and bronchial dilatation on chest X-ray, 62.8% had emphysema on chest computed tomography, in which the most common was the centrilobular emphysema form. The mean FEV1 was 45.35 ± 16.76%, mean FVC was 75.25 ± 21.67%, mean Gaensler was 45.05 ± 9.6; Mean TLC was 124.15 ± 35.43%, mean RV was 180.88 ± 95.9%, mean FRC was 161.67 ± 66.74%, mean RV/TLC was 138.74 ± 39.98%. The ratio of TLC, RV, FRC, RV/TLC ≥ 120% was 47.4%, 74.4%, 70.6%, 67.3% respectively; TLC has a univariate linear correlation with factors such as smoking, mMRC, barrel chest, snoring rales, decreased or absent alveolar murmur, alveolar dilatation on radiographs, emphysema on microscopy count; In the multivariable linear correlation analysis, the barrel chest is the most influential factor to increase the TLC value. Conclusion: The ratio of TLC, RV, FRC, RV/TLC ≥ 120% was 47.4%, 74.4%, 70.6%, 67.3% respectively. TLC has a univariate linear correlation with factors such as smoking, mMRC, barrel chest, snoring rales, decreased or absent alveolar murmur, alveolar dilatation on radiographs, emphysema on microscopy count. The barrel-shaped thorax is an independent predictor of increased TLC.